Developing an infection can be complicated enough, but when the body's immune system reacts by going into overdrive in the form of sepsis, every second counts. The diagnosis needs to be swift and, if sepsis is confirmed, interventions in the form of fluids and antibiotics must be administered immediately. Because the global death rate from sepsis remains painfully high — tens of millions each year — stepped-up efforts to reduce mortality have been underway on a global scale for at least the past decade. And there is progress to report on multiple continents where many health care organizations have been working hard on sepsis, often as part of international initiatives such as the Surviving Sepsis Campaign and in concert with professional societies such as the Society of Critical Care Medicine.

In the US, where 25 percent of the 750,000 people who develop sepsis each year die, North Shore–Long Island Jewish (NSLIJ) Health System has reduced its sepsis mortality rate significantly. North Shore–LIJ is now in the midst of a strategic partnership with IHI to maintain and further these gains, and key learning has begun to emerge. WIHI host Madge Kaplan explores this progress on reducing deaths from sepsis with three clinical leads from North Shore–LIJ and two improvement leaders from IHI. Early detection and intervention are key, but in order to execute best practices reliably, changing the culture and engaging the leadership of the organization have proven essential. At North Shore–LIJ, focusing on the emergency department has also been foundational to testing best practices and spreading them to the rest of the hospital system.

Don't miss this very important discussion about a critical problem that everyone in acute care needs to be aware of and working on. Patients and families are getting engaged too.

North Shore-LIJ Health System (now Northwell Health) launched a strategic partnership with the Institute for Healthcare Improvement to accelerate the pace of sepsis improvement, focusing initially on sepsis recognition and treatment in emergency departments (EDs). The health system reduced overall sepsis mortality by approximately 50 percent in a six-year period and increased compliance with sepsis resuscitation bundle elements in the EDs and inpatient units in 11 acute care hospitals.

IHI faculty for the Rethinking Critical Care seminar discuss and try to clarify some important and often misunderstood points about implementing care bundles (such as the Ventilator Bundle and the Central Line Bundle).

The Severe Sepsis Bundles include the Severe Sepsis 3-Hour Rescuscitation Bundle and the 6-Hour Septic Shock Bundle. The Severe Sepsis Bundles have been revised in conjunction with the updated 2012 International Guidelines for Management of Severe Sepsis and Septic Shock.

This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.